Fluency Disorders Flashcards
What is stuttering?
a communication disorder in which sounds, syllables, or words are repeated, stopped, or prolonged, disrupting the normal flow of speech.
What is the accepted term for someone who stutters?
Person Who Stutters (PWS)
what is fluency?
smooth speech transitions between sounds, syllables, and words
What are 3 factors associated with fluency?
Rate (appropriate speech timing), effort (appropriate force), and continuity (smooth connections without unnecessary pauses)
What is disfluency?
disruptions in the transitions between sounds, syllables, and words
T/F: disfluencies are present in the speech of people who do not stutter
true
When does a fluency problem become a fluency disorder?
when one crosses over the limits of normal disfluencies, it causes the listener to pay attention to how the person is talking, not what they are saying
What are the 6 parts to a stuttering disorder?
overt speech characteristics, secondary behaviors, physical alterations, affective features, cognitive features, social dynamics
What are some typical disfluencies?
phrase repetitions, whole word repetitions, interjections, and revisions
What are some stuttering-like disfluencies?
sound and syllable repetitions, blocks, and prolongations
What are secondary behaviors associated with stuttering?
loss of eye contact, facial movements, head movements, body movements
What are possible physical responses to stuttering?
rapid heart rate, change in breathing pattern, feeling tightness in chest or throat, sweating
What are affective features?
How a PWS feels about themselves, how a PWS feels about stuttering
What are cognitive features?
what the PWS thinks about themselves, what the PWS thinks about stuttering
what is lifetime incidence?
the number of all cases ever exhibited
What is the incidence of stuttering?
8% or higher
what is prevalence?
the number of all cases currently identified
What is the prevalence of stuttering?
less than 1%
what is the stuttering incidence for gender?
childhood: 2 males to 1 females
adulthood: 4 males to 1 female
what is the stuttering incidence with age?
incidence and prevalence decline across the life span
what is the cause of stuttering?
no current consensus on a cause, theories on psychological, psychosocial, and biological causes
At what age does stuttering start?
Mean - 33 months
T/F: Parents who believe that their child has begun stuttering are typically correct
true
T/F: Stuttering does not appear to arise from normal disfluency
true
What does early stuttering sound like
repetitions of initial syllable, sounds and short words are most typical (may include prolongations and blocks)
50% have tense movements
what are the best estimates of a child developing into a CWS?(4)
strong family history, more boys than girls, steady or increasing SLDs, onset later than typical 33 months
How do SLPs know who is a CWS?
add the SLDs and other disfluencies together, divide SLD/TD,
if 40% or more of TDs are SLDs, there is a potential problem
What percent of disfluencies in CWS are SLDs?
66% (2/3)
What is some advice an SLP should give to a parent of a CWS? (5)
decrease various pressures
decrease emotional and physical excitement
more relaxed, slowed paced activities
speak slower, especially to the child
promote child’s self confidence
What should an SLP tell a parent to do when their child stutters?
(6)
pay attention to the message
listen patiently as a child stutters
repeat child’s stuttered word
“say this easily again”
reinforce fluency
show empathy
When is direct therapy needed for pre-school age children?
when the child is aware and has negative reactions
secondary behaviors are present
high risk family history
high risk environment
What are some therapy approaches for CWS?
(3)
child-centered activities follow “fluency rules” (slow speech, smooth speech, soft voice, turn taking)
foster child’s positive self-image
SLP occasionally “pseudo-stutters” and acts unconcerned
how are adults who stutter different from children who stutter?
persistence of stuttering behaviors
frequent increase in stuttering behaviors
emotional, cognitive, and social reactions can expand over time
T/F: Adults who stutter are more likely to have a genetically-based more resistant stuttering
true
Assessment of stuttering in adults
- stuttering history
- treatment history
- current speech description
- secondary behaviors
- environmental variable affecting speech
- impact of stuttering on quality of life
What can the severity of stuttering be determined by?
frequency, duration, secondary behaviors, naturalness of speech
how can convert aspects of stuttering be measured?
rating scales, questionnaires
What is the OASES?
Overall Assessment of the Speaker’s Experience of Stuttering
What are the sections of the OASES?
- General information about stuttering
- affective, behavioral, cognitive reactions
- communication in daily situations
- impact of stuttering on quality of life
Can stuttering in older children and adults be cured?
No, the need for treatment can reoccur
what is the fluency shaping approach to stuttering therapy?
the goal is (near) 100% fluency; PWS learns new ways of speaking; behavior modifications; gradual increase in length and complexity
what is the stuttering modification approach to therapy?
the goal is to stutter more gently and less often; PWS learns to change speech as stutter happens or is about to happen; addresses covert thoughts/feelings
what are the fluency shaping techniques?
decreased rate of speech
gentle voice onset
light touches of articulators
coordinate breath and speech
stringing words together
what are the pros of fluency shaping?
can work well with young children
positive short-term effects
high % of fluency is attractive to PWS
what are the cons of fluency shaping?
little to no focus on covert feelings/thoughts
little to no focus on secondary behaviors
speakings concerned about sounding natural
difficult to maintain over time
what are the components of stuttering modification? (4)
- identification
- desensitization
- variation
- approximation
what is the identification component of stuttering modification?
the PWS labels and counts disfluencies
what is the desensitization component of stuttering modification?
PWS freezes in stuttered moments, watch themselves in mirror, confront negative thoughts
what is the variation component of stuttering modification?
PWS learns to manipulate and change disfluencies, learns to tolerate stuttering
what is the approximation component of stuttering modification?
PWS learns to modify disfluent moments to stutter more easily, with less struggle and effort
